Protecting America from Smallpox

This partial transcript of the Fox News Channel broadcast War on Terror: The Hunt for the Killers, November 27, 2001, was provided by the Federal Document Clearing House. Click here to order the complete transcript.

(BEGIN VIDEO CLIP)

DR. ANTHONY FAUCI, CENTERS FOR DISEASE CONTROL: Certainly smallpox is a threat, a bioterrorist threat. It's a particularly concerning threat because we're a victim of our own success, in many respects, in that we were successfully able to eradicate smallpox, and because of that, the last vaccinations that were given routinely in this country were in 1972.

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DHUE: Smallpox — the highly contagious virus is a threat to every American tonight, even those with the vaccine, because health officials like Dr. Anthony Fauci, whom we heard from a moment ago, say there is a good chance the vaccine is no longer potent enough to save your life.

Officials at the Centers for Disease Control and Prevention in Atlanta are not taking any chances after the anthrax attacks, and today they released their brand-new response plan if bioterrorists strike with smallpox. The drastic measures include quarantining entire cities and shutting down transportation systems.

Well, joining me now from Washington is a bioterrorism expert, Jonathan Tucker of the Monterey Institute of International Studies. He's also the author of Scourge: The Once and Future Threat of Smallpox.

Hello, and welcome to you.

JONATHAN TUCKER, BIOTERRORISM EXPERT: Good to be with you.

DHUE: Nice to have you here. OK, what do you make of the CDC's plan, which says that we should not vaccinate everyone in the country? What do you make of this?

TUCKER: I think it's a reasonable strategy because the vaccine itself is not an entirely safe product. When we were routinely vaccinating children back in the '60s, between two and four per million developed either died or developed permanent brain damage as a result of vaccination. So it does make sense to use the vaccine in a targeted way, to identify people with the disease and vaccinate around them to create a kind of firebreak to prevent the disease from spreading.

DHUE: I want to take a look at some smallpox facts that we've put together. You've been very involved in this. In fact, you were instrumental in the eradication of this disease. Let's put up a few facts about smallpox. It's the only infectious disease ever eradicated by man. The last outbreak was in 1949. The last naturally occurring case of smallpox in the world was in Somalia in 1977. U.S. ended vaccinations in 1972. And it kills about 30 percent of its victims.

OK, it ended. We ended vaccinations nearly 30 years ago. You're saying we don't need to vaccinate everybody. But we need to have some stockpiled, don't we?

TUCKER: Yes. And in fact, the government is doing two things. It's trying to extend our existing stockpile, which is somewhere between 7.5 and 15 million doses, by diluting it either fivefold or even tenfold. And that will extensively expand the available stockpile until we can produce more. And the government is moving very aggressively to commission the pharmaceutical industry to produce up to 250 million doses, in addition to what we already have.

DHUE: But that takes time, doesn't it?

TUCKER: Well, they're hoping to have the additional vaccine by the end of next year, though that's a very ambitious objective.

DHUE: Would it be too late? Let's say there's an outbreak in a month. Is it too late to save people if we don't have enough vaccines until a year from now?

TUCKER: Well, if we can dilute the existing stocks, we would have between 60 and 75 million doses. If the vaccine is used in a targeted way and we can isolate people with the disease and vaccinate everyone who might have come in contact with them — close family, friends and anyone who interacted with that person, let's say came within six feet of that individual — we can prevent the disease from spreading. And that was the strategy that was used successfully during the eradication campaign, when we eliminated the natural disease.

DHUE: So far, between 80 and 100 CDC employees have been vaccinated, but there are no plans to vaccinate state workers. That includes police, firefighters, health workers, the people who might be initially involved in dealing with some kind of an outbreak. Why shouldn't these people be vaccinated? And how can they be expected to go in and handle the situation if they're not protected in advance?

TUCKER: Well, one reason is that we have very limited stocks, so we have to harbor the and use them only where necessary. The reason CDC officials have been vaccinated is they would be the ones who would go in and actually confirm a diagnosis of smallpox. But the vaccine works very rapidly. In fact, if you're vaccinated within three days of exposure, you can still be protected from getting the disease. So first responders could be vaccinated just before they go in and start vaccinating other people. That's a fairly unique aspect of the smallpox vaccine.

DHUE: The CDC is talking about quarantining entire cities. You think about the population of New York City or Los Angeles or wherever, and you think how on Earth could that happen? How do you do that? Can you quarantine an entire city?

TUCKER: I think it's unrealistic, but I think what we really have to do is to detect an outbreak of smallpox, which, I should add, is not likely event. It is a potentially catastrophic but not a likely event.

DHUE: Why isn't it likely?

TUCKER: It's because the disease was eradicated 30 years ago, and the virus only exists in a few laboratories. The concern is that it may have fallen into the hands of rogue states, such as Iraq and North Korea, but it would still be difficult for terrorists to get their hands on the virus.

But I think, in terms of the way to contain an outbreak, we need to detect it at the earliest possible stage, when it is possible to contain it fairly readily. Once it has spread widely, then it would be much more difficult to contain.

DHUE: Final question. Should we all be very concerned about smallpox in this country?

TUCKER: I don't think we should be panicked about this threat. It's obviously something we should be prepared for and should have vaccine on the shelf and people trained to vaccinate, so in the unlikely event that there is an outbreak of this disease, will be able to deal with it. It is what is known as a low probability but high consequence threat.

DHUE: Yes.

TUCKER: Probably won't occur, but if it does, it could be catastrophic, which is why we need to be prepared.

DHUE: Preparation always the key. Bioterrorism expert Jonathan Tucker, thanks very much for being with us tonight.

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